NCBTMB Client Assessment and Planning 5 — Questions and Answers
Question 1: A client states they had a total knee replacement 8 weeks ago and have been cleared by their orthopedic surgeon for massage. What assessment step is MOST important before beginning?
- Check skin temperature and color distal to the incision site (Correct answer)
- Test the tensile strength of the scar tissue
- Perform passive knee flexion to assess range of motion
- Ask the client to perform a squat to assess functional recovery
Correct answer: Check skin temperature and color distal to the incision site
Assessing skin temperature, color, and swelling distal to a recent surgical site helps identify signs of circulatory compromise or infection before treatment.
Question 2: Which of the following BEST describes the purpose of a treatment goal set during client assessment and planning?
- To satisfy insurance billing requirements
- To establish measurable outcomes that guide treatment decisions and evaluate progress (Correct answer)
- To inform the client of all possible massage techniques available
- To determine how much the client will pay per session
Correct answer: To establish measurable outcomes that guide treatment decisions and evaluate progress
Treatment goals provide measurable benchmarks that guide clinical decisions and allow the therapist to objectively evaluate whether the treatment is effective.
Question 3: A client taking NSAIDs (e.g., ibuprofen) for chronic back pain arrives for treatment. The main clinical consideration is:
- NSAIDs cause hypertension, so blood pressure must be checked
- NSAIDs may mask pain, increasing the risk of overworking tissues without client feedback (Correct answer)
- NSAIDs strengthen muscles, so deeper pressure is appropriate
- NSAIDs are a contraindication to all massage modalities
Correct answer: NSAIDs may mask pain, increasing the risk of overworking tissues without client feedback
Because NSAIDs reduce pain perception, clients may not accurately report discomfort during treatment, increasing risk of tissue damage from excessive pressure.
Question 4: During assessment, a client demonstrates a positive straight leg raise test at 40 degrees with radiating pain down the leg. This result most likely indicates:
- Tight hamstring muscles
- A potential lumbar nerve root compression or herniated disc (Correct answer)
- Piriformis syndrome causing sciatic referral
- Normal flexibility for an older adult
Correct answer: A potential lumbar nerve root compression or herniated disc
A positive SLR at less than 45 degrees with radicular symptoms strongly suggests lumbar nerve root irritation, often from a herniated disc.
Question 5: A client who is 20 weeks pregnant comes in for her first prenatal massage. The most important assessment consideration specific to pregnancy is:
- Checking for varicose veins and avoiding those areas
- Confirming obstetric provider clearance and assessing for contraindicated positions such as prone (Correct answer)
- Avoiding all abdominal work regardless of symptoms
- Testing grip strength to assess fetal positioning
Correct answer: Confirming obstetric provider clearance and assessing for contraindicated positions such as prone
Prenatal massage requires provider clearance and careful positioning assessment since prone positioning is contraindicated in later pregnancy due to uterine compression risks.
Question 6: A client reports that their pain 'moves around' to different body areas from session to session. This pattern should prompt the therapist to:
- Treat whichever area is painful at each session
- Consider fibromyalgia or systemic pathology and recommend physician evaluation (Correct answer)
- Increase the frequency of sessions to keep up with the changing symptoms
- Document the pattern and continue the current treatment plan
Correct answer: Consider fibromyalgia or systemic pathology and recommend physician evaluation
Migratory pain with no clear local cause is a red flag for systemic conditions such as fibromyalgia, rheumatoid arthritis, or other pathologies requiring medical evaluation.
Question 7: Which principle of informed consent requires the therapist to explain all potential risks of the proposed treatment to the client BEFORE beginning?
- Voluntary participation
- Disclosure (Correct answer)
- Competence
- Comprehension
Correct answer: Disclosure
The disclosure principle of informed consent mandates that the therapist fully explain treatment risks, benefits, and alternatives so the client can make an educated decision.
NCBTMB Client Assessment and Planning 5
A client states they had a total knee replacement 8 weeks ago and have been cleared by their orthopedic surgeon for massage.
What assessment step is MOST important before beginning?